Role of ultrasonography for acute cholecystic conditions in the emergency room.

UNLABELLED: THE AIM of this study was to analyse the performance of ultrasonography in the diagnosis of gallbladder conditions requiring surgical intervention.

MATERIAL AND

METHODS

We performed an observational retrospective study for the assessment of ultrasound in patients having symptomatic gallbladder lithiasis.

RESULTS

The study group included 179 patients with a mean age of 59.31 +/- 15.82 years. The Kruskal Wallis test showed statistically significant differences (KW, p=0.00003) between the mean thickness of the gallbladder wall found in the 4 morphological types of cholecystitis. The statistical significance analysis using "Risk Ratio"(RR) and "Odd test"(OR) showed an increased risk in patients having documented gallbladder lithiasis to develop catarrhal cholecystitis (RR=1.19; OR=1.32, 95% CI 0.71-2.44). For the diagnosis of gallbladder lithiasis during acute cholecystitis, we found a 100% sensitivity, 98.7% specificity, with a 98.7% PPV, 100% NPV and a 93.39% method accuracy. For the diagnosis of various types of acute cholecystitis, we found a 89.99% sensitivity, 84.44% specificity, 88.31% PPV, 86.09% NPV, with a 87.35% method accuracy.

CONCLUSIONS

Ultrasonography is a method of high accuracy in the diagnosis of gallbladder lithiasis (93.39%) and its complication--acute cholecystitis (87.35%). The risk analysis for the occurrence of gallbladder complications and the increased risk for developing a severe form of acute cholecystitis in patients without documented lithiasis proves the essential contribution of ultrasonography in optimizing emergency surgical decision and therapy.